Healthcare Provider Details

I. General information

NPI: 1912487208
Provider Name (Legal Business Name): THRIVE COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3207 SPARKS RD # 200
CHEYENNE WY
82001-6152
US

IV. Provider business mailing address

3207 SPARKS RD # 200
CHEYENNE WY
82001-6152
US

V. Phone/Fax

Practice location:
  • Phone: 307-287-8882
  • Fax: 307-222-0279
Mailing address:
  • Phone: 307-287-8882
  • Fax: 307-222-0279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAURA KIETELL
Title or Position: OWNER/CEO
Credential: LCSW
Phone: 307-369-4710